Bottom Line:
The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001).In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022).The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively.

Affiliation: Department of Internal Medicine, Pusan National University College of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, Korea.

ABSTRACTHemoglobin is the predominent pigment in the gastrointestinal mucosa, and the development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, by using a hemoglobin index (IHb). The aims of this study were to make a software program to calculate the IHb and then to investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma with regard to its value for discriminating between the histologic types. We made a software program for calculating the IHb in the endoscopic images. By using this program, the mean values of the IHb for the carcinoma (IHb-C) and those of the IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type intramucosal gastric carcinomas. We then analyzed the ratio of the IHb-C to the IHb-N (C/N ratio). The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001). In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022). The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for making quantitative measurement of the endoscopic color in the intramucosal gastric carcinoma, and the C/N ratio by using the IHb would be helpful for distinguishing the diffuse-type carcinoma from the intestinal-type carcinoma.

Figure 4: (A) Electronic endoscopic image of an intestinal-type gastric carcinoma in the body of the stomach. The first marking was done on the margin of the carcinoma and then the second marking was done on the surrounding non-cancerous mucosa. (B) The mean IHb was calculated from the data of the picture elements on the described area. The C/N ratio was 1.26 (IHb-C: 37.7, IHb-N: 30.0).

Mentions:
Without the information of the histologic type, one gastroenterologist calculated the mean values of the IHb for the carcinoma (IHb-C) and the mean values of the IHb for the surrounding non-cancerous mucosa (IHb-N) in each of the regions of the interest. We mainly used the doughnut-type method for the area selection (Fig. 4, 5) but this was impossible in 37 endoscopic images. At that time, we used the user-defined method. Then, we analyzed the ratio of the IHb-C to the IHb-N (C/N ratio).

Figure 4: (A) Electronic endoscopic image of an intestinal-type gastric carcinoma in the body of the stomach. The first marking was done on the margin of the carcinoma and then the second marking was done on the surrounding non-cancerous mucosa. (B) The mean IHb was calculated from the data of the picture elements on the described area. The C/N ratio was 1.26 (IHb-C: 37.7, IHb-N: 30.0).

Mentions:
Without the information of the histologic type, one gastroenterologist calculated the mean values of the IHb for the carcinoma (IHb-C) and the mean values of the IHb for the surrounding non-cancerous mucosa (IHb-N) in each of the regions of the interest. We mainly used the doughnut-type method for the area selection (Fig. 4, 5) but this was impossible in 37 endoscopic images. At that time, we used the user-defined method. Then, we analyzed the ratio of the IHb-C to the IHb-N (C/N ratio).

Bottom Line:
The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001).In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022).The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively.

Affiliation:
Department of Internal Medicine, Pusan National University College of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, Korea.

ABSTRACTHemoglobin is the predominent pigment in the gastrointestinal mucosa, and the development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, by using a hemoglobin index (IHb). The aims of this study were to make a software program to calculate the IHb and then to investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma with regard to its value for discriminating between the histologic types. We made a software program for calculating the IHb in the endoscopic images. By using this program, the mean values of the IHb for the carcinoma (IHb-C) and those of the IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type intramucosal gastric carcinomas. We then analyzed the ratio of the IHb-C to the IHb-N (C/N ratio). The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001). In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022). The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for making quantitative measurement of the endoscopic color in the intramucosal gastric carcinoma, and the C/N ratio by using the IHb would be helpful for distinguishing the diffuse-type carcinoma from the intestinal-type carcinoma.